Patients' concerns about medical errors during hospitalization.

Background: A clear understanding of patients' understanding and perceived risk of medical errors is needed. Multiwave telephone interviews were conducted in 2002 with 1,656 inpatients from 12 Midwestern hospitals regarding patients' conceptualization of medical errors and perceived risk of seven types of medical errors.

Results: Patients defined medical errors to include not only clinical mistakes but also falls, communication problems, and responsiveness.

Reporting and disclosing medical errors: pediatricians' attitudes and behaviors.

Objective: To characterize pediatricians' attitudes and experiences regarding communicating about errors with the hospital and patients' families.

Design: Cross-sectional survey.

Setting: St Louis, Mo, and Seattle, Wash.

CT findings of a unicameral calcaneal bone cyst containing a fluid-fluid level.

Calcaneal unicameral bone cysts often contain fluid, but rarely contain fluid-fluid levels. We present a case focusing on the CT findings of a large calcaneal bone cyst with a fluid-fluid level and a review of the literature.

Severe acute respiratory syndrome coronavirus protein 6 accelerates murine coronavirus infections.

One or more of the unique 3'-proximal open reading frames (ORFs) of the severe acute respiratory syndrome (SARS) coronavirus may encode determinants of virus virulence. A prime candidate is ORF6, which encodes a 63-amino-acid membrane-associated peptide that can dramatically increase the lethality of an otherwise attenuated JHM strain of murine coronavirus (L. Pewe, H.

US and Canadian physicians' attitudes and experiences regarding disclosing errors to patients.

Background: Patients are often not told about harmful medical errors. The malpractice environment is considered a major determinant of physicians' willingness to disclose errors to patients. Yet, little is known about the malpractice environment's actual effect on physicians' error disclosure attitudes and experiences.

Choosing your words carefully: how physicians would disclose harmful medical errors to patients.

Background: A gap exists between patients' desire to be told about medical errors and present practice. Little is known about how physicians approach disclosure. The objective of the present study was to describe how physicians disclose errors to patients.

Brief report: Hospitalized patients' attitudes about and participation in error prevention.

Background And Objective: Although many patient safety organizations and hospital leaders wish to involve patients in error prevention, it is unknown whether patients will take the recommended actions or whether error prevention involvement affects hospitalization satisfaction.

Design And Participants: Telephone interviews with 2,078 patients discharged from 11 Midwest hospitals.

Results: Ninety-one percent agreed that patients could help prevent errors.

Palmitoylations on murine coronavirus spike proteins are essential for virion assembly and infectivity.

Coronavirus spike (S) proteins are palmitoylated at several cysteine residues clustered near their transmembrane-spanning domains. This is achieved by cellular palmitoyl acyltransferases (PATs), which can modify newly synthesized S proteins before they are assembled into virion envelopes at the intermediate compartment of the exocytic pathway. To address the importance of these fatty acylations to coronavirus infection, we exposed infected cells to 2-bromopalmitate (2-BP), a specific PAT inhibitor.

How surgeons disclose medical errors to patients: a study using standardized patients.

Background: Calls are increasing for physicians to disclose harmful medical errors to patients, but little is known about how physicians perform this challenging task. For surgeons, communication about errors is particularly important since surgical errors can have devastating consequences. Our objective was to explore how surgeons disclose medical errors using standardized patients.

A severe acute respiratory syndrome-associated coronavirus-specific protein enhances virulence of an attenuated murine coronavirus.

Most animal species that can be infected with the severe acute respiratory syndrome-associated coronavirus (SARS-CoV) do not reproducibly develop clinical disease, hindering studies of pathogenesis. To develop an alternative system for the study of SARS-CoV, we introduced individual SARS-CoV genes (open reading frames [ORFs]) into the genome of an attenuated murine coronavirus. One protein, the product of SARS-CoV ORF6, converted a sublethal infection to a uniformly lethal encephalitis and enhanced virus growth in tissue culture cells, indicating that SARS-CoV proteins function in the context of a heterologous coronavirus infection.

Development and implementation of a Clerkship Counseling Hotline.

Background: The 3rd year of medical school is stressful, yet students may hesitate to access their school's mental health services.

Description: We instituted the Clerkship Counseling Hotline, an anonymous, 24-hour cell phone hotline staffed by an independent counselor.

Evaluation: Hotline calls were logged, and students were surveyed regarding the hotline.

Patient concerns about medical errors in emergency departments.

Objective: Despite large numbers of emergency encounters, little is known about how emergency department (ED) patients conceptualize their risk of medical errors. This study examines how safe ED patients feel from medical errors, which errors are of greatest concern, how concerns differ by patient and hospital characteristics, and the relationship between concerns and willingness to return for future care.

Methods: Multiwave telephone interviews of 767 patients from 12 EDs were conducted.

Augmentation of special-needs services and information to students and teachers "ASSIST"--a telehealth innovation providing school-based medical interventions.

An innovative school-based telehealth technology was introduced in Hawaii with the purposes of: (1) evaluating students for medical/developmental conditions with educational implications, (2) providing a professionally-monitored Internet-based system of learning/development, and (3) delivering medically-based physical and occupational therapy at the students school. Electronically recorded satisfaction surveys from parents, teachers, and providers revealed significant improvement in all three areas.

Using focus groups to understand physicians' and nurses' perspectives on error reporting in hospitals.

Background: To increase error reporting, a better understanding of physicians' and nurses' perspectives regarding medical error reporting in hospitals, barriers to reporting, and possible ways to increase reporting is necessary.

Methods: Nine focus groups--four with 49 staff nurses, two with 10 nurse managers, and three with 30 physicians--from 20 academic and community hospitals were conducted in May-June 2002 in the St. Louis metropolitan area.

A prescription for protecting the doctor-patient relationship.

The relationship between patients and their physicians is fundamental to high-quality care, yet this relationship is under stress in the current healthcare environment. Health plans have instituted a variety of policies to contain costs, not fully appreciating the adverse effect these decisions have on the doctor-patient interaction. Legislators have responded to the public's concern about managed care with "patient protection" bills that fail to address the fundamental causes of tension between doctors and patients.

Requirements for CEACAMs and cholesterol during murine coronavirus cell entry.

Previous reports have documented that cholesterol supplementations increase cytopathic effects in tissue culture and also intensify in vivo pathogenicities during infection by the enveloped coronavirus murine hepatitis virus (MHV). To move toward a mechanistic understanding of these phenomena, we used growth media enriched with methyl-beta-cyclodextrin or cholesterol to reduce or elevate cellular membrane sterols, respectively. Cholesterol depletions reduced plaque development 2- to 20-fold, depending on the infecting MHV strain, while supplementations increased susceptibility 2- to 10-fold.

Specific regulation of T helper cell 1-mediated murine colitis by CEACAM1.

Carcinoembryonic antigen-related cellular adhesion molecule 1 (CEACAM1) is a cell surface molecule that has been proposed to negatively regulate T cell function. We have shown that CEACAM1 is associated with specific regulation of T helper cell (Th)1 pathways, T-bet-mediated Th1 cytokine signaling, and Th1-mediated immunopathology in vivo. Mice treated with anti-mouse CEACAM1-specific monoclonal antibody (mAb) CC1 during the effector phase exhibited a reduced severity of trinitrobenzene sulfonic acid colitis in association with decreased interferon (IFN)-gamma production.